Blood Components (Based on Book)

What are the 3 Types of Whole Blood Components?

1) Whole Blood

2) Whole Blood Irradiated

3) Whole Blood Leukocyte Reduced

What is the Storage and Transport Temperature for Whole Blood Components?

Storage → 1-6° C

Transport → 1-10° C

If a Whole Blood product is Irradiated, what is the new expiration date?

Original expiration date or 28 days; whichever is sooner

A blood product with CPD/CP2D is good for how many days?

21 Days

A blood product with CPDA-1 is good for how many days?

35 Days

What is the expiration of a product using an Open System

Changes to 24 hours

Which RBC Products Require Storage of -65° or Colder?

1) Frozen RBCs with 40% Glycerol

2) Frozen Rejuvenated RBCs

What is the Expiration for Frozen RBCs with 40% Glycerol?

10 Years

After collection, how many days do you have to freeze RBCs?

6 Days

Which RBC Products require Storage of 1-6°C and Transport of 1-10°C?

1) Normal RBCs

2) Deglycerolized RBCs

3) Deglycerolized Rejuvenated RBCs

4) Rejuvenated RBCs

5) Irradiated RBCs

6) Leuko Reduced RBCs

7) Washed RBCs

For RBC products, ADSOL can be used. What is the expiration date using this?

42 Days

For Deglycerolized RBCs and LR-RBC, the expiration for Open System is 24 hours. But what about in Closed System?

14 days

For Rejuvenated RBCs, what specific solution should be used and what should you do after rejuvenation?

Use AS-1 and Freeze

What is the Expiration date for Washed RBCs?

24 Hours

For normal Platelet Product, what is the Storage and Transport Temperature?

20-24 °C but requires continuous gentle agitation in storage

Why is necessary to maintain agitation of Platelets?

1) Proper gas exchange to prevent hypoxia as platelets continue to consume Oxygen

2) Maintain proper pH of 6.2

• Otherwise, platelets revert to anaerobic metabolism with increased Lactic Acid buildup

3) Prevent clumping

What is the Maximum Time that platelets can be stored WITHOUT agitation?

No more than 30 hours

What is the expiration of Platelets?

up to 5 days

What is the Storage and Transport temperature for Cold-Stored Platelets?

Storage → 1-6 °C with optional agitation

Transport → 1-10°C

If an Open System is used for Platelets, what is the expiration date?

4 Hours

If a Closed System is used for Platelets, what is the expiration date?

No Change in expiration date

What are the other Platelet Products (aside from cold stored)?

• Irradiated Platelets

• Leukocyte Reduced Platelets

• Leukocyte Reduced Pooled Platelets

• Pooled Plate in Open System

• Apheresis Platelets

• Irradiated Apheresis PLT

• Leukocyte Reduced Apheresis PLT

For Apheresis Granulocytes, what is the Storage and Transport Temp? What is the expiration?

Storage → 20-24°C

Transport → 20-24°C

Expiration → 24 Hours (should be transfused ASAP)

What is the Storage and Transport Temp for Cryoprecipitated AHF? What is the expiration?

Storage → -18 °C or colder

Transport → maintain frozen state

Expiration → 12 months from original collection

How is Cryoprecipitated AHF generally prepared?

1) Slowly thaw FFP at 1-6°C

2) This will cause cryoglobulins and proteins to form insoluble precipitate

3) Separate using centrifuge

4) Re-suspend in plasma

5) Freeze within 1 hour

What are the Main clotting factors/proteins found in the Cryoprecipitated AHF?

• Fibrinogen

• Factor VIII (AHF)

• vWF

• Factor XIII

• Fibronectin

After thawing Cryoprecipitated AHF at 30-37°C, how should it be stored, transported, and what is the expiration?

Storage → 20-24° C

Transport → maintain temp'

Expiration → 6 units if single unit; if pooled in an open system then 4 hours only

What is the Storage and Transport Temp for FFP?

Storage → -18 °C or colder / -65°C or Colder

Transport → Maintain temp

Expiration → if -18°C then 12 months; if -65°C then 7 years

After thawing FFP at 30-37°C, what is the Storage and Transport Temp? What is the expiration if this issued as FFP?

Storage → 1-6 °C

Transport → 1-10°C

Expiration → If issued as FFP, then 24 hours

How soon should plasma be Frozen if producing FFP? What about PF24?

FFP → freeze within 8 hours of collection

PF24 → freeze within 24 hours after phlebotomy

For PF24, what is the Storage and Transport temp? What is the expiration?

Storage → -18°C or colder

Transport → maintain temp

Expiration → 12 months after collection

After thawing PF24 at 30-37 °C, what is the Storage and Transport temp? And expiration if issued as PF24?

Storage → 1-6°C

Transport → 1-10°C

Expiration → if issued, then 24 hours

What are the Storage Lesions that affect stored RBCs?

• Decreased ATP Levels → reduces membrane integrity and deformability

• Decreased 2,3-BPG → Left shift in O2 dissociation curve; increased O2 affinity with less O2 delivery to tissues

• Decreased pH due to Lactic Acid buildup from anaerobic glycolysis

• Increased Free Hemoglobin

• Increased K+ with hemolysis (leakage)

• Morphological changes

• Increased lysophospholipids due to oxidative damage

Why is it recommended to transfuse “fresher” RBC units for neonates needing >25 mL/kg of blood?

To reduce the risk of Hyperkalemia

What are the metabolic changes that affect Stored Platelets?

• Increased Lactic acid due to glycolytic metabolism

• Increased CO2 due to oxidative metabolism of free fatty acids

How is pH of 6.2 or above maintained in stored platelets?

Maintained by buffering of lactic acid by bicarbonate and promotion of oxidative metabolism via gas-permeable storage bag with ongoing agitation

Because platelets are stored at room temperature, what risk are they prone to?

Risk of bacterial contamination

→ facilities should have means of detecting and monitoring

Should Granulocytes be agitated or leukocyte reduced?

NEVER

What patients are Granulocytes typically administered?

To immunocompromised recipients, which means Irradiation should be performed to prevent TA-GVHD

How is FFP Thawed?

• Place into plasma overwrap then submerge into 30-37°C waterbath

• Then, store in 1-6°C for max of 24 hours

• If more than 24 hours, must be re-labeled as Thawed Plasma

Why is Thawed Plasma not suitable for single-factor replacement?

It contains reduced concentrations of Factor V, Factor VII, and Factor VIII compared to FFP

How are RBCs frozen with glycerol prepared for transfusion?

• Thaw at 37°C using dry heater or water bath

• Then, remove the glycerol via washing

• Confirm adequate washing by measuring free hemoglobin

How is Platelet Gel produced?

Produced when thrombin and calcium are added to Platelet-rich plasma to produce glue-like substance for surgical application

What is the required irradiation dose?

25 gray (Gy)

→ to prevent proliferation of donor T lymphocytes in recipient

Who is at risk of TA-GVHD?

• Profoundly immunocompromised patients

• Recipients of intrauterine transfusions

• Recipients undergoing transplantation from → marrow, umbilical cord blood, peripheral blood stem cells

• Recipients of cellular components from blood relatives or donors selected for HLA compatibility or platelet crossmatch compatibility

For leukocyte reduced products (RBCs, platelets), how much leukocytes should be present in 95% of the units?

should be less than 5 × 10⁶ leukocytes

How is volume reduction performed for RBC and platelet components?

Partially remove plasma and additive solutions

Why is Volume Reduction of components important?

• Reduce risk for TACO

• Reduce exposure to plasma proteins or additives

• Minimize ABO antibody content

• Reduce risk of repeated transfusion reactions and to achieve target HCT level

What are the Indications for Washing RBCs or Platelets?

• Recipient with history of severe allergic reactions to components containing plasma

• Presence of IgA antibodies in IgA-deficient recipients

• Presence of HPA-1a antibodies when using maternal blood for neonatal transfusion

• Need for complement removal for recipients experiencing post-transfusion purpura

• Intrauterine transfusions (to remove preservatives and excess potassium)

• Also performed to remove glycerol in frozen RBCs